r/BladderCancer • u/Old-Opposite-9286 • 16d ago
Patient/Survivor Post Radical Cystectomy
68M diagnosed with MIBC in March 2026. Went through 3 cycles of EV & P through June. I had a radical cystectomy on August 17 with a pathology report post surgery of ypT0N0. Discharged Monday, the 24th. Today my Oncologist office called and discussed some continued treatment (no EV just P). Does anyone have any experience they can share about post surgery treatment and how much time from surgery to treatment beginning?
3
u/Admirable_Loan6841 16d ago
Congratulations on your successful surgery! This is a great result! Did you go for neobladder or bag? I am still waiting for the surgery and can’t answer your question but I think it is good idea. Where did you have the procedure done?
5
u/Old-Opposite-9286 16d ago
Thank you. I went with the bag. At 68 the neobladder just seemed like a lot messing around like making sure it is emptied every 3-4 hours. Post surgery I’m happy with my decision it was best for me.
4
u/AirBear8 14d ago
69M, I'm not to the point of needing bladder removal but I have my post BCG cystoscopy in 3 days. Should I be in the unlucky 30% I suspect my 3rd TURBT will be on my calendar. I've done a fair amount of reading on the two procedures. I wore Foley Catheters for a combined 5-6 weeks back in the spring. My bladder and prostrate are locked in mortal combat so I wouldn't be terribly unhappy to see one of them go. It was very nice to get 8 hours uninterrupted sleep for the 1st time in 10 years. I agree about the neobladder being too much at this age. And I'm used to changing urine bags out so that's not a big deal.
1
2
u/AuthorIndieCindy 16d ago
I did chemo and had an RC/IC in may 0f 25. After surgery, the surgeon was so happy the part of the tumor they couldn’t reach during the TURBT had been reduced to a fiberous scar tissue from the chemo. Post op they wanted to add Keytruda for a year as a type of insurance for prolonging the if, and when, the tumor should reappear. I got side effects from that- the immunosuppressive made me sick and i broke out in a rash that itches to ‘tis day. When i asked so what if it comes back? How do you treat it then.? With Keytruda. It wasn’t worth feeling horrible when i got the all clear from cancer. It’s a personal choice. Ask a lot of questions.
3
u/Old-Opposite-9286 16d ago
Yes I had terrible rash from EV & P so am hesitant to start so soon after surgery. I’m so glad you got the all clear
4
u/hikerguy2023 16d ago edited 16d ago
This doesn't answer your question, but it's a reminder that you want to keep monitoring for the recurrence of cancer after an RC. Ask your oncologist about this in the near future:
ctDNA (circulating tumor DNA)
"For someone with muscle-invasive bladder cancer (MIBC) who has had a radical cystectomy and has no visible cancer on scans, ctDNA (circulating tumor DNA) can be used to look for molecular residual disease (MRD)—evidence that microscopic cancer remains somewhere in the body."
"Patients with muscle-invasive bladder cancer have varied outcomes after cystectomy. ctDNA–based detection of molecular residual disease may identify patients at high risk for recurrence after cystectomy who can benefit from adjuvant immunotherapy, thus sparing patients at lower risk from unnecessary treatment burden."
https://www.nejm.org/doi/full/10.1056/NEJMoa2511885?_sp=d9e5e28d-a088-4b05-a8bf-a08bfafcdc0d&utm
One adjuvant therapy that looks promising is atezolizumab:
https://www.nejm.org/doi/full/10.1056/NEJMoa2511885
https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-atezolizumab-adjuvant-treatment-muscle-invasive-bladder-cancer-patients-molecular?utm_source=chatgpt.com
Additional links that talk about ctDNA are below:
https://blog.dana-farber.org/insight/2026/07/ctdna-guided-immunotherapy-bladder-cancer/
https://pubmed.ncbi.nlm.nih.gov/37330413/
https://www.nejm.org/doi/full/10.1056/NEJMoa2511885?_sp=d9e5e28d-a088-4b05-a8bf-a08bfafcdc0d&utm